HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Right and left ventricular remodeling after orthotopic single lung transplantation for end-stage emphysema.

AbstractBACKGROUND:
Orthotopic single lung transplantation (LTX) is now an established treatment modality for patients with end-stage emphysema. LTX has been shown to cause unloading of the right ventricle with improvement in right ventricular (RV) structure and function both immediately and up to weeks after surgery, mostly in patients with severe pulmonary hypertension and decreased RV function. Long-term effects of lung transplantation on both RV and left ventricular (LV) anatomy and function, however, are not well known.
METHODS:
Seventeen patients undergoing LTX for end-stage emphysema and preserved RV function underwent serial electron beam computed tomography RV and LV function studies before, 3 months after, 1 year after, and 2 years after transplantation. Right-sided heart catheterization was performed before transplantation and at 1 and 2 years follow-up.
RESULTS:
RV end systolic volume decreased significantly (-15.5%), and RV ejection fraction increased significantly (+16%) in the first 3 months after LTX. This change was paralleled by a decrease in pulmonary pressure and vascular resistance, indicating a permanent RV unloading. This improvement was maintained up to 2 years after LTX. LV end-diastolic volume (+25%), LV stroke volume (+29%), and LV muscle mass (+28%) increased significantly in the first 3 months after LTX. This remodeling was maintained during the 2-year follow-up.
CONCLUSIONS:
Significant changes in cardiac anatomy and function occur shortly after LTX, most likely as a consequence of adaptation to a new hemodynamic state in patients with well preserved RV function before LTX. Furthermore, these acute changes persist for at least 2 years after LTX.
AuthorsB J Rensing, J C McDougall, J F Breen, W T Vigneswaran, C G McGregor, J A Rumberger
JournalThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation (J Heart Lung Transplant) Vol. 16 Issue 9 Pg. 926-33 (Sep 1997) ISSN: 1053-2498 [Print] United States
PMID9322143 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Heart Ventricles (pathology)
  • Hemodynamics (physiology)
  • Humans
  • Lung Transplantation (physiology)
  • Male
  • Postoperative Complications (pathology, physiopathology)
  • Pulmonary Emphysema (surgery)
  • Ventricular Function, Left (physiology)
  • Ventricular Function, Right (physiology)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: